Event Details - Please indicate whether the following items pertain to your event. Complete by applicant.
YES NO
Closures and Police
Street or Sidewalk Closure, Detour Signs? provide names:
Parking Lot(s) Closure, names:
Fencing, Barrier(s) and / or Barricade(s) or Traffic Cones? which:
> Detour signs may be needed.
> Sawhorses used to block off streets with a sign indicating that the streets are closed for block party may be obtained
from the Municipal Services Highways Division at 978-623-8800 on the Friday before your event between hours of 7AM
to 3PM. Applicants assume responsibility for damage or theft of horses.
> Streets must be accessible at all times for emergency vehicles.
> All residents of the street(s) affected must be notified prior to the event that the streets will be blocked off for this event.
Request/ require Police Detail, (not typically required for Block Party)
Food Services or Alcoholic Beverages
Food Concession and/or Food Truck, Describe:
>Block parties must abide by Town of Andover Bylaws (A.12 S.20.5b) regulating the consumption of
alcoholic beverages on public ways.
Licenses or permission for
Will you be holding a raffle or game of chance? (Town Clerk's Office) Describe:
Music and/or Amplified Sound - If yes please indicate Start Time End Time
> The Town of Andover requires noise at reasonable levels and only until 9 PM.
Will your event have Entertainment? - describe:
Amusement Rides (Building Dept.)- list and describe:
Inflatable Device(s) (Building Dept.) – list and describe:
Facilities, Utilities and Structures
Canopy (ies) and or Tent(s) (Building Dept.)- describe & dimensions:
Town Manager - 978-623-8210 * Municipal Services – 978-623-8700 * Municipal Services Highways Div. - 978-623-8800
Police Dept. - 978-475-0411 X1034 * Health Div. - 978-623-8640 * Town Clerk's Office – 978-623-8230 *
Building Div. (Building, Plumbing, Electrical) - 978-623-8620
Special Events Contacts:
002
Other Permits
Please note that all components of the event are subject to approval by the Town Manager's Office and may also
require approval by and/or permit(s) from other Town agencies and departments. It is the responsibility of the
applicant to secure all necessary Town of Andover permits, and submit payments required for permits.
Affidavit of Applicant
My signature below indicates that everything I have stated in this application is correct to the best of my knowl-
edge. I have read, understand and agree to abide by the policies, rules and regulations of the Town of Andover as
they pertain to the requested usage. The permit, if granted is non-transferable and is revocable at any time at the
absolute discretion of the Town of Andover Town Manager’s Office (or designee). All programs and facilities of
the Town of Andover are open to all citizens regardless of race, sex, age, color, religion, national origin or disabil-
ity.
Signature of Applicant: _____________________________________ Date:_____________________________________
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signature
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